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American Journal of Neuroradiology 26:525-530, March 2005
© 2005 American Society of Neuroradiology

INTERVENTIONAL

Intracranial Angioplasty without Stenting for Symptomatic Atherosclerotic Stenosis: Long-Term Follow-up

Michael P. Marksa,c, Mary L. Marcellusa, Huy M. Doa,c, Pamela K. Schraedley-Desmonda, Gary K. Steinbergc, David C. Tongb and Gregory W. Albersb

a Department of Radiology, Stanford University Medical Center, Stanford, CA
b Department of Neurology, Stanford University Medical Center, Stanford, CA
c Department of Neurosurgery, Stanford University Medical Center, Stanford, CA, Stanford University Medical Center, Stanford, CA

Address reprint requests to Michael P. Marks, MD, Department of Radiology, Rm S-047, Stanford University Medical Center, 300 Pasteur Dr, Stanford, CA 94305

BACKGROUND AND PURPOSE: Angioplasty and stent placement have been reported for the treatment of intracranial stenosis. This study was undertaken to assess the efficacy and long-term clinical outcome of angioplasty without stent placement for patients with symptomatic intracranial stenosis.

METHODS: A retrospective study was done to evaluate 36 patients with 37 symptomatic atherosclerotic intracranial stenosis who underwent primary balloon angioplasty. All patients had symptoms despite medical therapy. Thirty-four patients were available for follow-up ranging from 6 to 128 months. Mean follow-up was 52.9 months.

RESULTS: Mean pretreatment stenosis was 84.2% before angioplasty and 43.3% after angioplasty. The periprocedural death and stroke rate was 8.3% (two deaths and one minor stroke). Two patients had strokes in the territory of angioplasty at 2 and 37 months after angioplasty. The annual stroke rate in the territory appropriate to the site of angioplasty was 3.36%, and for those patients with a residual stenosis of ≥50% it was 4.5%. Patients with iatrogenic dissection (n = 11) did not have transient ischemic attacks or strokes after treatment.

CONCLUSION: Results of long-term follow-up suggest that intracranial angioplasty without stent placement reduces the risk of further stroke in symptomatic patients.




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